Well the last blog seemed to attract very mixed responses with some people feeling I should have expressed more obvious fury. In fact, I’ve been outraged for many years with the role Dominic Cummings has taken in government. But I was interested in coming at the story from a different angle and had been quite haunted by that picture of him running away from Downing Street back in March when the prime-minister had just tested positive. He looked consumed with child-like panic and not at all the cold, ultra-rational, manipulative person we usually connect with his name. Of course, anyone can panic, but anxiety does not fit comfortably within this proud man’s psyche, and for all its careful stage-managing, this lack of psychological integration seemed very obvious in the incoherent story that emerged in the rose garden of Number 10. His refusal to admit or apologise for potentially putting others at risk when, virally-loaded, he took off to Durham, and his failure to see the potential impact of his behaviour on our thinking and collective determination, is telling. There is something perverse about his evident capacity to both acknowledge and deny reality at one and the same time.
But in a democracy we tend to get leaders who reflect the collective traits that are predominant in the population at that point in our history. I know we didn’t vote for Cummings but he was part of the package and it seems he has become so enmeshed with the Prime Minister’s thinking that it’s as if he’s become Johnson’s auxiliary ego. Personally, I was not surprised that this self-defined outsider should think himself entitled to behave differently from the rest of us. And the struggle to rationalise one’s mistakes, deny something one already knows, to ‘turn a blind eye’, is very familiar to me as a psychotherapist. For me, the retrospective amending of his blog and subsequent boasting that he had warned us many months ago of a corona virus pandemic, seemed more deliberately manipulative and chilling. But these character traits of both the Prime Minister and his aide – including such frank dishonesty – have been evident for many years, and we elected him/them six months ago with a massive majority.
So maybe we have to look at ourselves and wonder why we have made such men so powerful. Or, put more gently, what is it about our culture at the present time that has allowed men with such character traits to rise to the top? There is evidence from various disciplines that we are collectively more dishonest than we used to be – false news is just the tip of the iceberg. Values such as individualism, consumerism and the idealisation of market forces have created institutions where people are used as a means to an end, as tools and commodities rather than respected citizens, and where ‘gaming’, fabrication, distortion of reality quickly follow. In short, there is evidence to suggest that our institutions are more perverse than they used to be, with ‘turning a blind eye’ a norm within many of them.
Anyone familiar with the Francis Reports about the shocking clinical conditions, the excess deaths and the underlying ruthless and dishonest culture at Mid Staffordshire NHS FoundationTrust, will be in no doubt that such thinking is relevant to our public services as well as private corporations. The Francis Report described a sinister process: forces at work striving actively to prevent acknowledgement of problems. Managers and leaders appeared to have ignored, or even silenced, feedback from staff at all levels that would have alerted them to the problem. Staff tried – more than a third of the 515 safety incident reports submitted by ward staff attributed the problem to inadequate staffing. Consultants found their incident reports downgraded to being minor events without consultation or investigation. A senior manager in the trust even called for a specialist independent investigator to remove any statements in his report suggesting that people had died because of poor care – because it would distress people and bring bad publicity for the trust.
There are parallels between this disturbing piece of NHS history and the way the government is managing the present situation. From the start, they have tried to bluff their way through, minimising the problems and exaggerating their achievements. What makes me particularly furious is not just the sheer number of UK deaths from this pandemic, but the fact that we have had more deaths in relation to our population size than any other country in the world, and the fact that this is not being reflected in the main headlines. There has been a lot of shocked press coverage about the figures from America (still way below us per head of population) but since the official government press conferences stopped showing graphs of international comparisons, there has been very little coverage of just how badly we are doing. This is not the case in the medical press: the British Medical Journal, for example, reflects a truly bleak national picture in relation to the rest of the world and in a damning editorial two weeks ago described the UK government’s response as “too little, too late, too flawed”. This week it calls for a rapid inquiry reporting within months and hopefully before a second wave so that we can put measures in place to mitigate the worst aspects of what has proved to be a deeply dysfunctional system of governance and administration.
So, whether or not Dominic Cummings is sacked, let’s make sure that neither he nor anyone else in this government – full of ministers adept at turning a blind eye – stop us from facing the reality of what’s going on in this ‘world beating’ country of ours.
Intelligent Kindness 
Really interested to hear about the BMJ article confirming’ the too little too late ‘ argument we are all suspecting. But I would be interested to hear the views and analysis of you and your colleagues on the official govt advisers Chris Whitty and Jennie Harries et al. . Looking at bits and bobs I have in texts and emails with family I see that I noted on 5th March that our GP surgery was saying ‘stay away if you have symptoms.( probably started earlier) On 11th March my Dad’s Care Home ( run by Barchester) closed to all visitors and my daughter Rebecca who has Italian and Spanish friends was telling me in no uncertain terms to not come down to London on the train for a course I was on. ( Reluctantly I didn’t) By 12th people certainly being told to self isolate if had symptoms and the term social distancing was around.
BUT Jennie Harries was saying large public gatherings made little difference so on March 11th thousands of Atletico Madrid fans came to Liverpool although, I now understand that by time they weren’t allowed in their own stadium in Madrid.
And on 19th March at the govt press conference the advisers stood at podiums less than 1m apart from Johnson in a room packed with journalists. I was shocked, and I remember Johnson saying in a vague way..shouldnt we stop this ? shouldn’t we go electronic or something? As if he wasn’t really being encouraged to heed his own advice. Most odd.
So my question is WHY were these advisers not more strident ? I do understand that they are civil servants, and the environment they work in and were no doubt appointed and promoted in ,( failure to invest in NHS and sort out social care system, failure to invest in contingency planning, happy go lucky / individual freedom loving Johnson, general arrogance that UK would be different etc etc,) but there is no denying in my mind that the advisers that I thought of as calm and informative and having professional integrity at the beginning were not speaking truth to power and not demonstrating by their own actions how serious it was. ( They could have at least made a fuss about the lecterns!!!) Of course most of them caught it, no surprise. And now they seem to be apologists for Govt ( though in recent weeks some have looked decidedly uncomfortable) What is your take on them and what’s driving them ?
It’s easy in hindsight to find voices that were sounding the alarm earlier, equally those who were saying don’t worry (
eg the herd immunity advisors who I clearly remember ) But who was advising Barchester Homes on 11th March ? But not us at those press conferences?
I love the I.K. debates, though unsettling…..must get back to allotment and cross stitch!
Ann
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Good question Ann, but I’m afraid I don’t know the answer. It’s becoming clear that the government have been given good advice on many occasions and not acted on it: an early recommendation to start to build testing capacity, and advice not to discharge hospital in-patients to care homes, for a starter. Many government announcements have clearly not been discussed with the relevant bodies responsible for implementing change of policy and there seems to be a blatant disregard for proper process: the changed advice on hospital visiting and the wearing of masks in hospital, the most recent example. It’s also pretty evident that expert advisors and civil servants are being ignored much of the time. I can’t imagine what Chris Whitty and co are thinking but maybe they think it is more responsible to fight from within rather than leave and give more power to, say, Dominic Cummings. The BMJ asks the same question as you in this week’s editorial: “Scientists and doctors in advisory roles face a dual obligation to the state and to the public. But what happens when the government’s integrity no longer matches your personal or professional integrity? Do you fight from within? Speak out? Resign? Regrettably, questions of conscience and duty must now be addressed.”
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I believe Bill Clinton is reputed to have said “denial is not only a river in Egypt”. I guess he should know. It is also a theme of many of the plays of the great American dramatist Arthur Miller. The British government is running the Americans close in becoming world-beaters at it.
What are Johnson, Cummins, Gove et al denying? The incompetence oozing from every pore in their (mis)handling of Covid-19. They got it wrong and late from the start and have been desperately trying to play catch up ever since. And, as Penny says, all their bluff, evasion and deceit contributes daily to the breakdown of trust between government and governed.
Pity the civil servants and scientists required to collude with this despairing crew blindly steering the ship of state on to the rocks.
So how do they get away with it? By infecting us with the same tendency. Our very vulnerability that breeds uncertainty and anxiety, combined with the restrictions on our movements and activities, and the huge economic price so many businesses and households are having to pay, make us fearful, cautious and hard- wired to risk. Under these conditions we can also operate in a state of denial, believing people we do not trust, giving them the benefit of the doubt (what doubt?) saying they should be allowed to get on with the job, deluding ourselves that they know what they are doing when they claim that they are “led by the science” – when they clearly are not in all cases.
I have been reading recently accounts of the experiences of clinicians and nurses in ICUs I found myself moved, shocked and amazed at the intensely difficult work they have been doing in the most testing of circumstances, effecting the most intricate procedures, both life threatening and life saving, making huge judgement calls when mind-numbingly exhausted and struggling to communicate with colleagues because if the PPE they wear. While doing so, I kept thinking of how the scale of this could have been lessened had better judgement calls been made earlier on in the pandemic by politicians clearly not up to the task.
Their ineptness is now being made evident each Wednesday at PMQs. In a shameful performance this week, Johnson turned angrily on the leader of the opposition accusing him of criticising instead of constructively contributing to the country’s recovery. So does not “the people’s democracy” provide for speaking truth to power and holding government to account?
We are told that the test and trace system is now on track and then today it is revealed that, in an internal webinar for staff Serco, the private outsourcing company, does not think the “world-beating” system will not be properly in place until September. Yet we are led to believe in an incremental lifting of restrictions between now and then.
You couldn’t make it up. It appears that denial is endemic in the pandemic. And the credulousness of so many is bewildering as they are faced every day with evidence of a government bluffing, ducking and dissembling. Led by donkeys does not even come close.
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Very well put. Thanks Bryan.
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I’m concerned about Serco’s taking over track and trace. Its a company owned and run by Winston Churchills grandson. This does not bode well for cronyism let alone their ability to manage such a service. Their record is appalling isn’t it?
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I can rail against the politicians as I have done and that brings short-term relief to some of the frustration and anger. And I can be stunned by the jaw-dropping coincidence of “I can’t breathe” being the words that stand so starkly for the twin scourges of the disease and racial injustice that have so transfixed they world over the last weeks.
And I remain deeply affected by the accounts I have read or seen recently of the toll that Covid-19 is taking on those clinical and nursing staff who are in the eye of the storm and keeping patients alive or caring for them as they die. I was deeply moved by the brilliantly written account of the work done by a the team in the ICU of a major London hospital and by the report from a hospital in Lodi, northern Italy where the senior clinician had moved from his home and family to another hospital many miles away where he has to sleep when he can on a chair in his office. And then yesterday I read a a lengthy report on huge concerns expressed by psychotherapists and psychiatrists about the immediate and longer term that Covid-19 is having on the mental and physical health of NHS staff some of whom are traumatised and exhausted and whose reserves of resilience, resolve and resourcefulness are being depleted. I know that Penny and others are providing much-needed help enabling these frontline workers to process their experience. And I wonder what the prognosis is for the workforce as tentative steps are taken by Government to lessen restrictions and enable a loosening of the lockdown.
The weekly clapping of gratitude and admiration for frontline and key workers has paused if not stopped. But last Thursday I stood with my wife on the doorstep in silence and I reflected on the amazing work that has been done and wondered how well equipped in all senses, including mental health, those in the frontline are going to be if and when we are hit by a second wave, as so many predict. How do clinicians and nurses feel as they anticipate a possible iteration in some form of what has already passed? What further levels of anxiety and dread are they having to manage? Or is the key to dealing with this living in the present and not recalling the past or imagining the future?
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